hstm20250630

hstm20250630_10q.htm

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 10-Q

(Mark One)

☒	Quarterly Report pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934

For the quarterly period ended June 30, 2025

☐	Transition Report Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934

Commission File No.: 000-27701

HealthStream, Inc.

(Exact name of registrant as specified in its charter)

Tennessee	62-1443555
(State or other jurisdiction of incorporation or organization)	(I.R.S. Employer Identification No.)

500 11th Avenue North, Suite 850,
Nashville, Tennessee	37203
(Address of principal executive offices)	(Zip Code)

(615) 301-3100

(Registrant's telephone number, including area code)

Title of each class	Trading Symbol(s)	Name of each exchange on which registered
Common Stock (Par Value $0.00)	HSTM	Nasdaq Global Select Market

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes ☒ No ☐

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.

Large accelerated filer	☐	Accelerated filer	☒
Non-accelerated filer	☐	Smaller reporting company	☐
Emerging growth company	☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ☐ No ☒

As of August 4, 2025, there were 29,641,207 shares of the registrant’s common stock outstanding.

Table of Contents

Index to Form 10‑Q

HEALTHSTREAM, INC.

		Page Number
Part I.	Financial Information	1
Item 1.	Financial Statements	1
	Condensed Consolidated Balance Sheets (Unaudited) – June 30, 2025 and December 31, 2024	1
	Condensed Consolidated Statements of Income (Unaudited) – Three and Six Months ended June 30, 2025 and 2024	2
	Condensed Consolidated Statements of Comprehensive Income (Unaudited) – Three and Six Months ended June 30, 2025 and 2024	3
	Condensed Consolidated Statement of Shareholders' Equity (Unaudited) – Three and Six Months ended June 30, 2025 and 2024	4
	Condensed Consolidated Statements of Cash Flows (Unaudited) – Six Months ended June 30, 2025 and 2024	5
	Notes to Condensed Consolidated Financial Statements (Unaudited)	6
Item 2.	Management's Discussion and Analysis of Financial Condition and Results of Operations	12
Item 3.	Quantitative and Qualitative Disclosures about Market Risk	18
Item 4.	Controls and Procedures	18
Part II.	Other Information	19
Item 1.	Legal Proceedings	19
Item 1A.	Risk Factors	19
Item 2.	Unregistered Sales of Equity Securities and Use of Proceeds	20
Item 5.	Other Information	20
Item 6.	Exhibits	21
	SIGNATURE	22

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PART I. FINANCIAL INFORMATION

Item 1. Financial Statements

HEALTHSTREAM, INC.

CONDENSED CONSOLIDATED BALANCE SHEETS (UNAUDITED)

(In thousands)

	*June 30,*			*December 31,*
	*2025*			*2024*
ASSETS
Current assets:
Cash and cash equivalents	$	52,102		$	59,469
Marketable securities		38,517			37,748
Accounts receivable, net		26,926			30,189
Accounts receivable - unbilled		4,541			5,133
Prepaid and other current assets		22,310			20,583
Total current assets		144,396			153,122

Property and equipment, net		11,914			10,741
Capitalized software development, net		44,580			43,370
Operating lease right of use assets, net		16,262			17,453
Goodwill		191,845			191,220
Intangibles, net		48,865			55,548
Other assets		42,286			39,312
Total assets	$	500,148		$	510,766

LIABILITIES AND SHAREHOLDERS’ EQUITY
Current liabilities:
Accounts payable	$	4,043		$	6,628
Accrued royalties		4,824			5,190
Accrued liabilities		11,815			10,141
Accrued compensation		6,320			9,507
Deferred revenue		88,376			84,227
Total current liabilities		115,378			115,693

Deferred tax liabilities		15,101			14,596
Deferred revenue, noncurrent		1,198			1,655
Operating lease liability, noncurrent		15,891			17,366
Other long-term liabilities		2,013			2,101
Commitments and contingencies

Shareholders’ equity:
Preferred Stock, no par value, 10,000 shares authorized, no shares issued or outstanding		—			—
Common stock, no par value, 75,000 shares authorized; 29,897 and 30,432 shares issued and outstanding at June 30, 2025 and December 31, 2024, respectively		235,041			252,432
Retained earnings		116,804			108,972
Accumulated other comprehensive loss		(1,278	)		(2,049	)
Total shareholders’ equity		350,567			359,355
Total liabilities and shareholders’ equity	$	500,148		$	510,766

See accompanying Notes to the unaudited Condensed Consolidated Financial Statements.

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HEALTHSTREAM, INC.

CONDENSED CONSOLIDATED STATEMENTS OF INCOME (UNAUDITED)

(In thousands, except per share data)

	*Three Months Ended*					*Six Months Ended*
	*June 30, 2025*		*June 30, 2024*			*June 30, 2025*			*June 30, 2024*
Revenues, net	$	74,396	$	71,556		$	147,881		$	144,316
Operating costs and expenses:
Cost of revenues (excluding depreciation and amortization)		26,364		23,738			51,851			48,355
Product development		12,073		12,076			24,121			24,107
Sales and marketing		11,808		11,405			23,958			23,179
General and administrative		7,398		9,556			16,066			17,868
Depreciation and amortization		10,867		10,370			21,621			20,706
Total operating costs and expenses		68,510		67,145			137,617			134,215

Operating income		5,886		4,411			10,264			10,101

Interest income		958		944			1,889			1,848
Other income (expense), net		23		(55	)		(39	)		(107	)

Income before income tax provision		6,867		5,300			12,114			11,842
Income tax provision		1,478		1,132			2,393			2,448
Net income	$	5,389	$	4,168		$	9,721		$	9,394

Net income per share:
Basic	$	0.18	$	0.14		$	0.32		$	0.31
Diluted	$	0.18	$	0.14		$	0.32		$	0.31

Weighted average shares of common stock outstanding:
Basic		30,320		30,401			30,382			30,357
Diluted		30,450		30,526			30,519			30,472
Dividends declared per share	$	0.031	$	0.028		$	0.062		$	0.056

See accompanying Notes to the unaudited Condensed Consolidated Financial Statements.

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HEALTHSTREAM, INC.

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (UNAUDITED)

(In thousands)

	*Three Months Ended*						*Six Months Ended*
	*June 30, 2025*			*June 30, 2024*			*June 30, 2025*			*June 30, 2024*
Net income	$	5,389		$	4,168		$	9,721		$	9,394

Other comprehensive income (loss), net of taxes:
Foreign currency translation adjustments		754			(44	)		803			(519	)
Unrealized loss on marketable securities		(13	)		(1	)		(32	)		(7	)
Total other comprehensive income (loss)		741			(45	)		771			(526	)
Comprehensive income	$	6,130		$	4,123		$	10,492		$	8,868

See accompanying Notes to the unaudited Condensed Consolidated Financial Statements.

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HEALTHSTREAM, INC.

CONDENSED CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY (UNAUDITED)

(In thousands, except per share data)

	*Six Months Ended June 30, 2025*
	*Common Stock*						*Retained*			*Accumulated Other Comprehensive*			*Total Shareholders’*
	*Shares*			*Amount*			*Earnings*			*(Loss)/Income*			*Equity*
Balance at December 31, 2024		30,432		$	252,432		$	108,972		$	(2,049	)	$	359,355
Net income		—			—			4,332			—			4,332
Comprehensive income		—			—			—			30			30
Dividends declared on common stock ($0.031 per share)		—			—			(943	)		—			(943	)
Stock-based compensation		—			1,104			—			—			1,104
Common stock issued under stock plans, net of shares withheld for employee taxes		93			(1,070	)		—			—			(1,070	)
Balance at March 31, 2025		30,525		$	252,466		$	112,361		$	(2,019	)	$	362,808
Net income		—			—			5,389			—			5,389
Comprehensive income		—			—			—			741			741
Dividends declared on common stock ($0.031 per share)		—			—			(946	)		—			(946	)
Stock-based compensation		—			836			—			—			836
Common stock issued under stock plans, net of shares withheld for employee taxes		22			(5	)		—			—			(5	)
Excise tax on repurchases of common stock					(135	)								(135	)
Repurchases of common stock		(650	)		(18,121	)								(18,121	)
Balance at June 30, 2025		29,897		$	235,041		$	116,804		$	(1,278	)	$	350,567

	*Six Months Ended June 30, 2024*
	*Common Stock*					*Retained*			*Accumulated Other Comprehensive*			*Total Shareholders’*
	*Shares*		*Amount*			*Earnings*			*Loss*			*Equity*
Balance at December 31, 2023		30,298	$	249,075		$	92,368		$	(691	)	$	340,752
Net income		—		—			5,227			—			5,227
Comprehensive loss		—		—			—			(481	)		(481	)
Dividends declared on common stock ($0.028 per share)		—		—			(849	)		—			(849	)
Stock-based compensation		—		1,060			—			—			1,060
Common stock issued under stock plans, net of shares withheld for employee taxes		100		(855	)		—			—			(855	)
Balance at March 31, 2024		30,398	$	249,280		$	96,746		$	(1,172	)	$	344,854
Net income		—		—			4,168			—			4,168
Comprehensive loss		—		—			—			(45	)		(45	)
Dividends declared on common stock ($0.028 per share)		—		—			(851	)		—			(851	)
Stock-based compensation		—		1,094			—			—			1,094
Common stock issued under stock plans, net of shares withheld for employee taxes		10		(6	)		—			—			(6	)
Balance at June 30, 2024		30,408	$	250,368		$	100,063		$	(1,217	)	$	349,214

See accompanying Notes to the unaudited Condensed Consolidated Financial Statements.

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HEALTHSTREAM, INC.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED)

(In thousands)

	*Six Months Ended June 30,*
	*2025*			*2024*
OPERATING ACTIVITIES:
Net income	$	9,721		$	9,394
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization		21,621			20,706
Stock-based compensation		1,940			2,154
Amortization of deferred commissions		6,017			5,956
Provision for credit losses		391			1,802
Deferred income taxes		467			(542	)
Loss on equity method investments		107			82
Other		(776	)		(746	)
Changes in operating assets and liabilities:
Accounts and unbilled receivables		3,465			449
Prepaid and other current assets		(1,728	)		(53	)
Other assets		(8,596	)		(5,516	)
Accounts payable and accrued expenses		(3,858	)		(8,912	)
Accrued royalties		(366	)		(370	)
Deferred revenue		3,692			2,985
Net cash provided by operating activities		32,097			27,389

INVESTING ACTIVITIES:
Proceeds from maturities of marketable securities		26,073			29,196
Purchases of marketable securities		(26,100	)		(34,526	)
Proceeds from sale of non-marketable equity investments		—			765
Purchase of other investments		(500	)		—
Payments associated with capitalized software development		(14,500	)		(13,552	)
Purchases of property and equipment		(3,372	)		(914	)
Net cash used in investing activities		(18,399	)		(19,031	)

FINANCING ACTIVITIES:
Taxes paid related to net settlement of equity awards		(1,075	)		(861	)
Payment of cash dividends		(1,890	)		(1,700	)
Repurchases of common stock		(18,121	)		—
Net cash used in financing activities		(21,086	)		(2,561	)

Effect of exchange rate changes on cash and cash equivalents		21			1
Net (decrease) increase in cash and cash equivalents		(7,367	)		5,798
Cash and cash equivalents at beginning of period		59,469			40,333
Cash and cash equivalents at end of period	$	52,102		$	46,131

NONCASH INVESTING AND FINANCING ACTIVITIES:
Purchases of property and equipment, accrued but not paid	$	87		$	167
Capitalized software development, accrued but not paid	$	611		$	383

See accompanying Notes to the unaudited Condensed Consolidated Financial Statements.

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HEALTHSTREAM, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)

1. OVERVIEW AND BASIS OF PRESENTATION

Company Overview

HealthStream provides primarily Software-as-a-Service ("SaaS") based applications for healthcare organizations—all designed to improve business and clinical outcomes by supporting the people who deliver patient care. The Company is focused on helping individuals and organizations in healthcare meet their ongoing learning, clinical development, credentialing, and scheduling needs. The Company also provides its solutions to nursing schools and nursing students.

The Company is organized and operated according to its One HealthStream approach, with its hStream technology platform at the center of that approach. Increasingly, SaaS-based applications in the Company's diverse ecosystem of solutions utilize the Company's proprietary hStream technology platform to enhance the value proposition for customers by creating interoperability with and among other applications. We believe that our single platform strategy, as represented by hStream, is the best way to realize our mission of improving the quality of care by developing the people who deliver care and the best way to create value for our shareholders in the process. As used in this Quarterly Report on Form 10-Q (“Form 10-Q”), “HealthStream,” “Company,” “we,” “us,” and “our” mean HealthStream, Inc. and its subsidiaries, unless the context indicates otherwise.

Basis of Presentation

The accompanying unaudited Condensed Consolidated Financial Statements have been prepared in accordance with accounting principles generally accepted in the United States (“US GAAP”) for interim financial information and with the instructions to Form 10‑Q and Article 10 of Regulation S‑X. Accordingly, condensed consolidated financial statements do not include all of the information and footnotes required by US GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation have been included. All intercompany transactions have been eliminated in consolidation and certain prior period amounts have been reclassified to conform to the current period presentation. Operating results for the three and six months ended June 30, 2025 are not necessarily indicative of the results that may be expected for the year ending December 31, 2025.

The Condensed Consolidated Balance Sheet at December 31, 2024 was derived from the audited Consolidated Financial Statements at that date but does not include all of the information and footnotes required by US GAAP for a complete set of financial statements. For further information, refer to the Consolidated Financial Statements and Notes thereto for the year ended December 31, 2024 (included in the Company's Annual Report on Form 10-K, filed with the Securities and Exchange Commission on February 28, 2025).

Business Segments

The Company’s chief operating decision maker ("CODM") is its Chief Executive Officer. Since January 1, 2023, the Company’s business has been organized and managed around a consolidated, enterprise approach, including with regard to technology, operations, accounting, internal reporting (including the nature of information reviewed by the CODM), organization structure, compensation, performance assessment, and resource allocation. The Company’s CODM uses consolidated net income to make operating decisions, assess financial performance, and allocate resources. Further, the CODM reviews and utilizes functional expenses (cost of revenues, product development, sales and marketing, general and administrative, and depreciation and amortization) at the consolidated level to manage the Company's operations. Other segment items included in consolidated net income are interest income, other income (expense), net, and income tax provision, which are reflected in the Condensed Consolidated Statements of Income. Expenditures for additions to long-lived assets for the consolidated entity were $23.2 million and $19.4 million for the six months ended June 30, 2025 and 2024, respectively.

Non-Marketable Equity Investments

The aggregate carrying amount of non-marketable equity investments accounted for using the measurement alternative for equity investments that do not have readily determinable fair values was $1.5 million as of June 30, 2025 and December 31, 2024, which the Company evaluates for impairment at each reporting period. Cumulatively, there have been no adjustments recorded due to changes in the fair value of the non-marketable equity investments the Company held as of June 30, 2025. The fair value of non-marketable equity investments is not estimated if there are no identified events or changes in circumstances that may have a significant adverse effect on the fair value of the investment.

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HEALTHSTREAM, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)

2. RECENT ACCOUNTING PRONOUNCEMENTS

In November 2023, the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update ("ASU") 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures. The new guidance requires disclosures of significant reportable segment expenses that are regularly provided to the CODM and other segment items on an interim and annual basis. Entities with a single reportable segment will also be required to apply the disclosure requirements in ASU 2023-07 on an interim and annual basis. ASU 2023-07 was effective for the Company for annual periods beginning after December 15, 2023 and interim periods within fiscal years beginning after December 15, 2024. The Company adopted this standard effective January 1, 2024 using a retrospective method.

In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures, which requires public entities to provide disclosure of disaggregated information in the entity’s tax rate reconciliation, as well as disclosure of income taxes paid disaggregated by jurisdiction. ASU 2023-09 is effective for fiscal years beginning after December 15, 2024. The Company is currently evaluating the effect of this standard on its disclosures and will adopt the standard effective for the annual period ending December 31, 2025.

In November 2024, the FASB issued ASU 2024-03, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures: Disaggregation of Income Statement Expenses, which requires disclosure of disaggregated information about specific categories underlying certain income statement expense line items in the footnotes to the financial statements for both annual and interim periods. This ASU is effective for fiscal years beginning after December 15, 2026, and interim reporting periods beginning after December 15, 2027. Early adoption is permitted. The Company is currently evaluating the impact of the adoption of this standard.

3. REVENUE RECOGNITION

Revenues are recognized when control of the promised goods or services is transferred to the customer in an amount that reflects the consideration the Company expects to be entitled in exchange for transferring those goods or services. Revenue is recognized based on the following five step model:

•

Identification of the contract with a customer

•

Identification of the performance obligations in the contract

•

Determination of the transaction price

•

Allocation of the transaction price to the performance obligations in the contract

•

Recognition of revenue when, or as, the Company satisfies a performance obligation

The following table represents revenues disaggregated by revenue source (in thousands). Sales taxes are excluded from revenues.

	*Three Months Ended June 30,*				*Six Months Ended June 30,*
	*2025*		*2024*		*2025*		*2024*
Subscription services	$	71,941	$	69,013	$	142,730	$	139,218
Professional services		2,455		2,543		5,151		5,098
Total revenues, net	$	74,396	$	71,556	$	147,881	$	144,316

For the three months ended June 30, 2025 and 2024, the Company recognized $0.2 million and $1.6 million in impairment losses on receivables and contract assets arising from the Company's contracts with customers, respectively. For the six months ended June 30, 2025 and 2024, the Company recognized $0.4 million and $1.8 million in impairment losses on receivables and contract assets arising from the Company's contracts with customers, respectively.

During the three months ended June 30, 2025 and 2024, the Company recognized revenues of $49.1 million and $47.2 million, respectively, from amounts included in deferred revenue at the beginning of the respective periods. During the six months ended June 30, 2025 and 2024, the Company recognized revenues of $69.1 million and $65.2 million, respectively, from the amounts included in deferred revenue at the beginning of the respective periods. As of June 30, 2025, approximately $618 million of revenue is expected to be recognized from remaining performance obligations under contracts with customers. The Company expects to recognize revenue related to approximately 39% of these remaining performance obligations over the next 12 months, 68% over the next 24 months, and 85% over the next 36 months, with the remaining amounts recognized thereafter.

4. INCOME TAXES

Income taxes are accounted for using the asset and liability method, whereby deferred tax assets and liabilities are determined based on the temporary differences between the financial statement and tax bases of assets and liabilities measured at tax rates that will be in effect for the year in which the differences are expected to affect taxable income. The Company computes its interim period provision for income taxes by applying the estimated annual effective tax rate to year-to-date pretax income or loss and adjusts the provision for discrete tax items recorded in the period. The Company’s effective tax rate was 20% and 21% for the six months ended June 30, 2025 and 2024, respectively. The Company’s effective tax rate primarily reflects the statutory corporate income tax rate, the net effect of state taxes, foreign income taxes, the effect of various permanent tax differences, and recognition of discrete tax items.

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HEALTHSTREAM, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)

On July 4, 2025, the federal budget reconciliation legislation, commonly referred to as the One Big Beautiful Bill ("OBBB”), was signed into law. The OBBB includes significant changes to federal tax law and other regulatory provisions that may impact the Company, including modifications to capitalization of research and development expenses, limitations on deductions for interest expense, and accelerated fixed asset depreciation. The Company is currently evaluating the provisions of the new law and the potential effects on its financial position, results of operations, and cash flows. As of the date of these financial statements, the Company has not completed its assessment, and, therefore, no adjustments have been made. Additional disclosures will be provided in future periods as the impact of the legislation is determined.

5. SHAREHOLDERS' EQUITY

Dividends on Common Stock

During the six months ended June 30, 2025, the Company's Board of Directors (“Board”) declared the following quarterly dividends under the Company's dividend policy (in thousands, except per share data):

Dividend Payment Date	Dividend Declaration Date	Dividend Per Share		Record Date	Cash Outlay
March 21, 2025	February 24, 2025	$	0.031	March 10, 2025	$	943
May 30, 2025	May 5, 2025	$	0.031	May 19, 2025	$	946

Additionally, on August 4, 2025, the Board declared a quarterly cash dividend of $0.031 per share, payable on August 29, 2025 to holders of record on August 18, 2025.

Stock-Based Compensation

The Company has stock awards outstanding under its 2016 Omnibus Incentive Plan and 2022 Omnibus Incentive Plan.

Stock Option Activity

A summary of stock option activity for the three months ended June 30, 2025 is as follows (in thousands, except weighted-average exercise price).

			*Weighted-*
	*Common*		*Average*		*Aggregate*
	*Shares*		*Exercise Price*		*Intrinsic Value*
Outstanding at beginning of period		90	$	20.34
Granted		—		—
Exercised		—		—
Expired		—		—
Forfeited		—		—
Outstanding at end of period		90	$	20.34	$	660
Exercisable at end of period		90	$	20.34	$	660

The weighted average remaining contractual term of options outstanding at June 30, 2025 was 5.4 years.

Restricted Share Unit Activity

A summary of Restricted Share Unit ("RSU") activity for the three months ended June 30, 2025 is as follows (in thousands, except weighted-average grant date fair value):

				*Weighted-*
	*Number of*			*Average Grant Date*		*Aggregate*
	*RSU’s*			*Fair Value*		*Intrinsic Value*
Outstanding at beginning of period		478		$	26.35
Granted		31			27.89
Vested		(22	)		26.02
Forfeited		(2	)		25.74
Outstanding at end of period		485		$	26.46	$	13,431

As of June 30, 2025, total unrecognized compensation expense related to non-vested RSUs was $6.4 million, net of estimated forfeitures, with a weighted average expense recognition period remaining of 2.6 years.

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HEALTHSTREAM, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)

Total stock-based compensation expense recognized in the Condensed Consolidated Statements of Income is as follows (in thousands):

	*Three Months Ended June 30,*				*Six Months Ended June 30,*
	*2025*		*2024*		*2025*		*2024*
Cost of revenues (excluding depreciation and amortization)	$	50	$	50	$	103	$	103
Product development		198		202		428		399
Sales and marketing		109		140		253		276
General and administrative		479		702		1,156		1,376
Total stock-based compensation expense	$	836	$	1,094	$	1,940	$	2,154

Share Repurchase Plan

On May 8, 2025, the Company announced a share repurchase program approved by the Company’s Board of Directors under which the Company is authorized to repurchase up to $25.0 million of its outstanding shares of common stock. Pursuant to this authorization, repurchases may be made from time to time in the open market, including under a Rule 10b5-1 plan, through privately negotiated transactions, or otherwise. During the three months ended June 30, 2025, the Company repurchased and subsequently retired 649,953 shares valued at $18.1 million pursuant to this authorization, and the Company continued to repurchase shares pursuant to this authorization during the third quarter, completing the program in July by repurchasing and retiring 255,833 shares valued at $6.9 million. The share repurchase program terminated in July when the maximum dollar amount was expended.

6. EARNINGS PER SHARE

Basic earnings per share is computed by dividing the net income available to common shareholders for the period by the weighted average number of common shares outstanding during the period. Diluted earnings per share is computed by dividing the net income available to common shareholders for the period by the weighted average number of potentially dilutive common and common equivalent shares outstanding during the period. Common equivalent shares are composed of incremental common shares issuable upon the exercise of stock options and RSUs subject to vesting. The dilutive effect of common equivalent shares is included in diluted earnings per share by application of the treasury stock method. The total number of common equivalent shares excluded from the calculations of diluted earnings per share, due to their anti-dilutive effect or contingent performance conditions, was approximately 184,000 and 155,000 for the three months ended June 30, 2025 and 2024, respectively, and 145,000 and 166,000 for the six months ended June 30, 2025 and 2024.

The following table sets forth the computation of basic and diluted earnings per share (in thousands, except per share data):

	*Three Months Ended June 30,*				*Six Months Ended June 30,*
	*2025*		*2024*		*2025*		*2024*
Numerator:
Net income	$	5,389	$	4,168	$	9,721	$	9,394
Denominator:
Weighted-average shares outstanding		30,320		30,401		30,382		30,357
Effect of dilutive shares		130		125		137		115
Weighted-average diluted shares		30,450		30,526		30,519		30,472

Net income per share:
Basic	$	0.18	$	0.14	$	0.32	$	0.31
Diluted	$	0.18	$	0.14	$	0.32	$	0.31

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HEALTHSTREAM, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)

7. MARKETABLE SECURITIES

The fair value of marketable securities, which were all classified as available for sale and which the Company does not intend to sell nor will the Company be required to sell prior to recovery of their amortized cost basis, included the following (in thousands):

	*June 30, 2025*
	*Adjusted Cost*		*Unrealized Gains*		*Unrealized Losses*			*Fair Value*
Level 2:
U.S. treasury securities	$	38,528	$	2	$	(13	)	$	38,517
Total	$	38,528	$	2	$	(13	)	$	38,517

	*December 31, 2024*
	*Adjusted Cost*		*Unrealized Gains*		*Unrealized Losses*			*Fair Value*
Level 2:
U.S. treasury securities	$	37,726	$	24	$	(2	)	$	37,748
Total	$	37,726	$	24	$	(2	)	$	37,748

The carrying amounts reported in the Condensed Consolidated Balance Sheets approximate fair value based on quoted market prices or alternative pricing sources and models utilizing market observable inputs. As of June 30, 2025 and December 31, 2024, the Company did not recognize any allowance for credit impairments on its available for sale securities. All investments in marketable securities are classified as current assets on the Condensed Consolidated Balance Sheets because the underlying securities mature within one year from the balance sheet date.

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HEALTHSTREAM, INC.

NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)

8. DEBT

Revolving Credit Facility

On October 6, 2023, the Company entered into an Amended and Restated Revolving Credit Agreement (“Revolving Credit Facility”), amending the Revolving Credit Facility dated as of November 24, 2014, as amended, with certain lenders party thereto from time to time, and Truist, as Administrative Agent for the lenders. Under the Revolving Credit Facility, the Company may borrow up to $50.0 million, which includes a $5.0 million swingline sub-facility and a $5.0 million letter of credit sub-facility, as well as an accordion feature that allows the Company to increase the Revolving Credit Facility by a total of up to $25.0 million, subject to securing additional commitments from existing lenders or new lending institutions. The Revolving Credit Facility has a maturity date of October 6, 2026.

The Company's obligations under the Revolving Credit Facility are unsecured. In addition, if the Company forms or acquires any domestic subsidiaries, the loans and other obligations under the Revolving Credit Facility will be guaranteed by such domestic subsidiaries.

At the Company’s election, the borrowings under the Revolving Credit Facility, other than the swingline loans, bear interest at either (1) a base rate defined as the highest of (a) the rate which the Administrative Agent announces from time to time as its prime lending rate, as in effect from time to time, or (b) the Federal Funds Rate, as in effect from time to time, plus one-half of one percent (0.50%) per annum (any changes in such rates to be effective as of the date of any change in such rate), plus in each case an applicable margin that varies with the company’s funded debt leverage ratio; or (2) a term secured overnight financing rate (“SOFR”) defined as the greater of (a)(i) the forward-looking term rate based on SOFR determined as of the reference time for such interest period with a term equivalent to such interest period plus (ii) a term SOFR adjustment equal to 0.10% per annum and (b) zero, plus, in each case, an applicable margin that varies with the Company’s consolidated total leverage ratio. The Company’s borrowings under the swingline loans bear interest at the base rate plus the applicable margin. The initial applicable margin for base rate loans is 0.50% and the initial applicable margin SOFR loans is 1.50%. The applicable margins will be adjusted quarterly, in each case two (2) business days after the Administrative Agent's receipt of the Company's quarterly financial statements. The Company is also required to pay a commitment fee accruing on the unused revolving commitment, which fee initially is 20 basis points per annum and a letter of credit fee, accruing at a rate per annum equal to the applicable margin for SOFR loans then in effect on the daily average amount of such lender’s letter of credit exposure.

Principal is payable in full at maturity on October 6, 2026, and there are no scheduled principal payments prior to maturity. Interest on base rate loans and swingline loans is payable quarterly in arrears, and interest on SOFR loans is payable at the end of each interest period, and in the case of interest periods longer than three months, on each day which occurs every three months after the initial date of such interest period.

The purpose of the Revolving Credit Facility is for general working capital needs, permitted acquisitions (as defined in the Amended and Restated Revolving Credit Agreement), and for stock repurchase and/or redemption transactions that the Company may authorize.

In addition, the Revolving Credit Facility required the Company to meet certain financial tests, including, without limitation:

•	a funded debt leverage ratio (consolidated debt/consolidated EBITDA) of not greater than 3.0 to 1.0; and

•	an interest coverage ratio (consolidated EBITDA/consolidated interest expense) of not less than 3.0 to 1.0.

In addition, the Revolving Credit Facility contains certain customary affirmative and negative covenants that, among other things, restrict additional indebtedness, liens and encumbrances, changes to the character of the Company’s business, acquisitions, asset dispositions, mergers and consolidations, sale or discount of receivables, creation or acquisitions of additional subsidiaries, and other matters customarily restricted in such agreements.

As of June 30, 2025, the Company was in compliance with all covenants. There were no balances outstanding on the Revolving Credit Facility as of or during the three and six months ended June 30, 2025.

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Item 2. Management's Discussion and Analysis of Financial Condition and Results of Operations

Special Cautionary Notice Regarding Forward‑Looking Statements

You should read the following discussion and analysis in conjunction with our Condensed Consolidated Financial Statements and related Notes included elsewhere in this Form 10-Q and our audited Consolidated Financial Statements and the Notes thereto for the year ended December 31, 2024, appearing in our Annual Report on Form 10-K that was filed with the Securities and Exchange Commission (“SEC”) on February 28, 2025 (the “2024 Form 10-K”). Statements contained in this Form 10-Q that are not historical facts are forward-looking statements that the Company intends to be covered by the safe harbor provisions for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995. Statements that are predictive in nature, that depend on or refer to future events or conditions, or that include words such as “anticipates,” “believes,” “could,” “estimates,” “expects,” “intends,” “may,” “plans,” “potential,” “predicts,” “projects,” “should,” “will,” “would,” and similar expressions are forward-looking statements.

The Company cautions that forward-looking statements involve known and unknown risks, uncertainties, and other factors that may cause actual results, performance, or achievements to be materially different from any future results, performance, or achievements expressed or implied by the forward-looking statements. Forward-looking statements reflect our current views with respect to future events and are based on assumptions and subject to risks and uncertainties. Given these uncertainties, you should not place undue reliance on these forward-looking statements.

In evaluating any forward-looking statement, you should specifically consider the information regarding forward-looking statements set forth above and the risks set forth under the caption Part I, Item 1A. Risk Factors in our 2024 Form 10-K and other disclosures in our 2024 Form 10-K, earnings releases, and other filings with the SEC from time to time, as well as other cautionary statements contained elsewhere in this Form 10-Q, including our critical accounting policies and estimates as discussed in this Form 10-Q and our 2024 Form 10-K. We undertake no obligation to update or revise any forward-looking statements. You should read this Form 10-Q and the documents that we reference in this Form 10-Q and have filed as exhibits to this Form 10-Q completely and with the understanding that our actual future results may be materially different from what we currently expect.

Business Overview

HealthStream provides primarily SaaS based applications for healthcare organizations—all designed to improve business and clinical outcomes by supporting the people who deliver patient care. We are focused on helping individuals and organizations in healthcare meet their ongoing learning, clinical development, credentialing, and scheduling needs. We also provide our solutions to nursing schools and nursing students.

Our business is managed and organized around a single platform strategy, also referred to as our One HealthStream approach. At the center of this single platform strategy is our hStream technology platform. By enabling our applications through hStream, we believe that stand-alone applications, which already provide a powerful value proposition on their own, are beginning to leverage each other to more efficiently and effectively empower our customers to manage their business and improve their outcomes. Further, the Company’s internal structure and executive leadership are likewise shaped by the organizing principle of a single platform, including with regard to technology, operations, accounting, internal reporting (including the nature of information reviewed by our key decision makers), organizational structure, compensation, performance assessment, and resource allocation.

Significant financial metrics for the second quarter of 2025 are set forth in the bullets below.

•	Revenues of $74.4 million in the second quarter of 2025, up 4.0% from $71.6 million in the second quarter of 2024

•	Operating income of $5.9 million in the second quarter of 2025, up 33.4% from $4.4 million in the second quarter of 2024

•	Net income of $5.4 million in the second quarter of 2025, up 29.3% from $4.2 million in the second quarter of 2024

•	Earnings per share (“EPS”) of $0.18 per share (diluted) in the second quarter of 2025, up from $0.14 per share (diluted) in the second quarter of 2024

•	Adjusted EBITDA¹ of $17.6 million in the second quarter of 2025, up 11.3% from $15.8 million in the second quarter of 2024

¹	Adjusted EBITDA is a non-GAAP financial measure. A reconciliation of adjusted EBITDA to net income and disclosure regarding why we believe adjusted EBITDA provides useful information to investors is included later in this Form 10-Q.

During the first quarter of 2025, we entered into an agreement to sublease a portion of our office space in the Capitol View building in Nashville, Tennessee to optimize our workforce performance to deliver positive results for customers, employees, and shareholders. HealthStream’s corporate headquarters remains in Nashville in the Capitol View building, while we continue to hire new employees both locally and nationally to support our growth. The sublease commenced in April 2025 and will expire in October 2031. We recorded sublease income, net of initial direct cost amortization, of $0.7 million during the three months ended June 30, 2025. In addition, we expect to record sublease income, net, of approximately $1.6 million during the last six months of 2025 and $3.2 million annually thereafter for the remaining term of the sublease under the caption General and Administrative.

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Recent Developments

Macroeconomic and other conditions in the U.S. that directly or indirectly impact the healthcare industry are challenging in certain respects and may become more challenging based on recent and contemplated changes to various policies and regulations. While healthcare costs continue to grow, government cuts or reimbursement rate reductions to funding for programs and organizations such as Federally Qualified Health Centers and academic medical institutions, the impact of tariffs on goods and services utilized by healthcare provider organizations, as well as uncertainty surrounding potential policy, regulatory, and economic shifts continue to be challenging for our healthcare customers. In particular, the federal reconciliation legislation enacted on July 4, 2025 includes significant policy changes that may adversely impact healthcare provider organizations, including changes that are expected to decrease access to health insurance and result in significant cuts to federal healthcare spending, particularly within the Medicaid program. We believe that these challenges and uncertainties, particularly among healthcare provider organizations with patient populations more dependent on government-funded reimbursement, have caused, and may in the future cause, some delays in purchasing and non-renewals of existing products and services, particularly in relation to elective or non-mandatory products and services.

Additionally, challenges persist in terms of inflationary pressures, ongoing elevated interest rate levels, lower consumer sentiment levels compared to recent periods, and heightened geopolitical tensions, including various ongoing and threatened conflicts abroad and strained global trade relations. We have experienced in certain recent periods, and believe that many of our customers have experienced, increased labor, supply chain, capital, and other expenditures and budgetary pressures associated with such conditions and challenges. These conditions and challenges impacting the U.S. economy and our customers in the healthcare industry have adversely affected, and may continue to adversely impact, our business and results of operations. Additionally, given our focus on customers in the healthcare industry, adverse developments impacting the healthcare industry, including as a result of the developments described above, may adversely impact our business and financial results, although we are unable to fully assess the impact to which we may be impacted by any such developments.

Key Financial Metrics

Our management utilizes the following financial metrics in connection with managing our business.

•

Revenues, net. Revenues, net, reflect income generated by the sales of goods and services related to our operations. Revenues, net, were $74.4 million and $147.9 million for the three and six months ended June 30, 2025, respectively, compared to $71.6 million and $144.3 million for the three and six months ended June 30, 2024, respectively. Management utilizes revenue in connection with managing our business and believes that this metric provides useful information to investors as a key indicator of the growth and success of our products.

•

Net Income. Net income represents revenues, net, less all expenses. Net income was $5.4 million and $9.7 million for the three and six months ended June 30, 2025, respectively, compared to $4.2 million and $9.4 million for the three and six months ended June 30, 2024, respectively. Management utilizes net income in connection with managing our business, including with regard to our capital deployment strategies.

•

Adjusted EBITDA. Adjusted EBITDA, calculated as set forth below under “Reconciliation of Non-GAAP Financial Measures,” is utilized by our management in connection with managing our business and provides useful information to investors because adjusted EBITDA reflects net income adjusted for certain GAAP accounting, non-cash, and/or non-operating items, as more specifically set forth below, which may not fully reflect the underlying operating performance of our business. We also believe that adjusted EBITDA is useful to investors to assess the Company’s ongoing operations. Additionally, certain short-term cash incentive bonuses and performance-based equity award grants are based, in whole or in part, on the achievement of adjusted EBITDA (as defined in applicable bonus and equity grant documentation) targets. Adjusted EBITDA was $17.6 million and $33.8 million for the three and six months ended June 30, 2025, respectively, compared to $15.8 million and $32.9 million for the three and six months ended June 30, 2024, respectively.

•

Capital Expenditures. Capital expenditures represent cash payments incurred for purchases of property and equipment and during the development phase for projects to develop software and content. Capital expenditures were $9.0 million and $17.9 million for the three and six months ended June 30, 2025, respectively, compared to $6.7 million and $14.5 million for the three and six months ended June 30, 2024, respectively. Management utilizes this metric in connection with managing the allocation of capitalized expenditures in which the Company invests related to the development of its products and believes that this metric is a key indicator of investment in products relative to their current and expected performance.

Critical Accounting Policies and Estimates

See Notes to the Consolidated Financial Statements in our 2024 Form 10-K and the Notes to the Condensed Consolidated Financial Statements herein which contain additional information regarding our accounting policies and other disclosures required by US GAAP. There have been no changes in our critical accounting policies and estimates from those reported in our 2024 Form 10-K.

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Three Months Ended June 30, 2025 Compared to Three Months Ended June 30, 2024

Revenues, net. Revenues increased $2.8 million, or 4%, to $74.4 million for the three months ended June 30, 2025 from $71.6 million for the three months ended June 30, 2024. Subscription revenues increased $2.9 million, or 4%, and professional services revenues decreased by $0.1 million, or 3%, compared to the second quarter of 2024.

A comparison of revenues by revenue source is as follows (in thousands):

	Three Months Ended June 30,
	2025			2024			Percentage Change
Subscription services	$	71,941		$	69,013			4	%
Professional services		2,455			2,543			-3	%
Total revenues, net	$	74,396		$	71,556			4	%

% of Revenues
Subscription services		97	%		96	%
Professional services		3	%		4	%

Cost of Revenues (excluding Depreciation and Amortization). Cost of revenues increased $2.7 million, or 11%, to $26.4 million for the three months ended June 30, 2025, from $23.7 million for the three months ended June 30, 2024. Cost of revenues as a percentage of revenues were 35% and 33% for the three months ended June 30, 2025 and 2024, respectively. The increase in amount is primarily associated with investments in several areas of our business, primarily in our platform and SaaS applications, resulting in higher costs for third-party software and cloud hosting as well as an increase in labor costs and royalties.

Product Development. Product development expenses was $12.1 million for both the three months ended June 30, 2025 and 2024. Product development expenses as a percentage of revenues were 16% and 17% for the three months ended June 30, 2025 and 2024, respectively.

Sales and Marketing. Sales and marketing expenses, including personnel costs, increased $0.4 million, or 4%, to $11.8 million for the three months ended June 30, 2025, from $11.4 million for the three months ended June 30, 2024. Sales and marketing expenses were 16% of revenues for both the three months ended June 30, 2025 and 2024. The increase in amount is primarily due to higher labor costs and increased staffing levels.

General and Administrative. General and administrative expenses decreased $2.2 million, or 23%, to $7.4 million for the three months ended June 30, 2025, from $9.6 million for the three months ended June 30, 2024. General and administrative expenses were 10% and 13% of revenues for the three months ended June 30, 2025 and 2024, respectively. The decrease in amount is primarily due to a decrease in bad debt expense associated with a customer bankruptcy that occurred during the three months ended June 30, 2024, coupled with sublease income associated with the sublease that commenced during the second quarter of 2025 as noted above.

Depreciation and Amortization. Depreciation and amortization expense increased $0.5 million, or 5%, to $10.9 million for the three months ended June 30, 2025, from $10.4 million for the three months ended June 30, 2024. This increase in amount is primarily a result of an increase in amortization associated with capitalized software.

Interest Income. Interest income was $1.0 million and $0.9 million for the three months ended June 30, 2025 and 2024, respectively. This increase is a result of an increase in cash and investment balances.

Other Income (Expense), Net. Other income (expense), net was income of $23,000 and expense of $55,000 for the three months ended June 30, 2025 and 2024, respectively. The change is primarily a result of foreign currency gains.

Income Tax Provision. The Company recorded a provision for income taxes of $1.5 million for the three months ended June 30, 2025, compared to $1.1 million for the three months ended June 30, 2024. The Company’s effective tax rate was 22% for the three months ended June 30, 2025, compared to 21% for the three months ended June 30, 2024. The Company’s effective tax rate primarily reflects the statutory corporate income tax rate, the net effect of state taxes, foreign income taxes, the effect of various permanent tax differences, and recognition of discrete tax items.

Net Income. Net income was $5.4 million and $4.2 million for the three months ended June 30, 2025 and 2024, respectively. EPS was $0.18 per share (diluted) and $0.14 per share (diluted) for the three months ended June 30, 2025 and 2024, respectively.

Adjusted EBITDA was $17.6 million for the three months ended June 30, 2025, compared to $15.8 million for the three months ended June 30, 2024. See “Reconciliation of Non-GAAP Financial Measures” below for our reconciliation of adjusted EBITDA to the most directly comparable measure under US GAAP and disclosure regarding why we believe adjusted EBITDA provides useful information to investors.

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Six Months Ended June 30, 2025 Compared to Six Months Ended June 30, 2024

Revenues, net. Revenues increased $3.6 million, or 2%, to $147.9 million for the six months ended June 30, 2025 from $144.3 million for the six months ended June 30, 2024. Subscription revenues increased $3.5 million, or 3%, compared to the six months ended June 30, 2024. Compared to the six months ended June 30, 2024, revenues for the six months ended June 30, 2025 were negatively impacted by several factors, including a $3.5 million reduction from attrition in legacy applications, a $1.1 million reduction from customer bankruptcies, and a $0.9 million reduction in perpetual license sales. These reductions to revenue were more than offset by $9.1 million of revenue growth across our portfolio of solutions.

A comparison of revenues by revenue source is as follows (in thousands):

	Six Months Ended June 30,
	2025			2024			Percentage Change
Subscription services	$	142,730		$	139,218			3	%
Professional services		5,151			5,098			1	%
Total revenues, net	$	147,881		$	144,316			2	%

% of Revenues
Subscription services		97	%		96	%
Professional services		3	%		4	%

Cost of Revenues (excluding Depreciation and Amortization). Cost of revenues increased $3.5 million, or 7%, to $51.9 million for the six months ended June 30, 2025, from $48.4 million for the six months ended June 30, 2024. Cost of revenues as a percentage of revenues were 35% and 34% for the six months ended June 30, 2025 and 2024, respectively. The increase in amount is primarily associated with investments in several areas of our business, primarily in our platform and SaaS applications, resulting in higher costs for cloud hosting and third-party software as well as an increase in labor costs.

Product Development. Product development expenses was $24.1 million for both the six months ended June 30, 2025 and 2024. Product development expenses as a percentage of revenues were 16% and 17% for the six months ended June 30, 2025 and 2024, respectively.

Sales and Marketing. Sales and marketing expenses, including personnel costs, increased $0.8 million, or 3%, to $24.0 million for the six months ended June 30, 2025, from $23.2 million for the six months ended June 30, 2024. Sales and marketing expenses were 16% of revenues for both the six months ended June 30, 2025 and 2024. The increase in amount is primarily due to higher labor costs and sales commissions.

General and Administrative. General and administrative expenses decreased $1.8 million, or 10%, to $16.1 million for the six months ended June 30, 2025, from $17.9 million for the six months ended June 30, 2024. General and administrative expenses were 11% and 12% of revenues for the six months ended June 30, 2025 and 2024, respectively. The decrease in amount is primarily due to a decrease in bad debt expense associated with a customer bankruptcy that occurred during the six months ended June 30, 2024, coupled with sublease income associated with the sublease that commenced during the second quarter of 2025 as noted above.

Depreciation and Amortization. Depreciation and amortization expense increased $0.9 million, or 4%, to $21.6 million for the six months ended June 30, 2025, from $20.7 million for the six months ended June 30, 2024. This increase in amount is primarily a result of an increase in amortization associated with capitalized software.

Interest Income. Interest income was $1.9 million and $1.8 million for the six months ended June 30, 2025 and 2024, respectively. This increase is a result of an increase in cash and investment balances.

Other Income (Expense), Net. Other income (expense), net was expense of $39,000 and $107,000 for the six months ended June 30, 2025 and 2024, respectively. The change is primarily a result of foreign currency gains.

Income Tax Provision. The Company recorded a provision for income taxes of $2.4 million for both the six months ended June 30, 2025 and June 30, 2024. The Company’s effective tax rate was 20% for the six months ended June 30, 2025, compared to 21% for the six months ended June 30, 2024. The Company’s effective tax rate primarily reflects the statutory corporate income tax rate, the net effect of state taxes, foreign income taxes, the effect of various permanent tax differences, and recognition of discrete tax items.

Net Income. Net income was $9.7 million and $9.4 million for the six months ended June 30, 2025 and 2024, respectively. EPS was $0.32 per share (diluted) and $0.31 per share (diluted) for the six months ended June 30, 2025 and 2024, respectively.

Adjusted EBITDA was $33.8 million for the six months ended June 30, 2025, compared to $32.9 million for the six months ended June 30, 2024. See “Reconciliation of Non-GAAP Financial Measures” below for our reconciliation of adjusted EBITDA to the most directly comparable measure under US GAAP and disclosure regarding why we believe adjusted EBITDA provides useful information to investors.

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Reconciliation of Non-GAAP Financial Measures

This Form 10-Q presents adjusted EBITDA, which is a non-GAAP financial measure used by management in analyzing our financial results and ongoing operational performance.

In order to better assess the Company’s financial results, management believes that net income before interest, income taxes, stock-based compensation, depreciation and amortization, and changes in fair value of, including gains (losses) on the sale of, non-marketable equity investments (“adjusted EBITDA”) is a useful measure for evaluating the operating performance of the Company because adjusted EBITDA reflects net income adjusted for certain GAAP accounting, non-cash, and/or non-operating items which may not, in any such case, fully reflect the underlying operating performance of our business. We believe that adjusted EBITDA is useful to investors to assess the Company’s ongoing operating performance and to compare the Company’s operating performance between periods. Additionally, certain short-term cash incentive bonuses and performance-based equity awards are based on the achievement of adjusted EBITDA (as defined in applicable bonus and equity grant documentation) targets.

Adjusted EBITDA is a non-GAAP financial measure and should not be considered as a measure of financial performance under GAAP. Because adjusted EBITDA is not a measurement determined in accordance with GAAP, adjusted EBITDA is susceptible to varying calculations. Accordingly, adjusted EBITDA, as presented, may not be comparable to other similarly titled measures of other companies and has limitations as an analytical tool.

A reconciliation of adjusted EBITDA to the most directly comparable GAAP measure, net income, is set forth below (in thousands).

Three Months Ended June 30,

SEC Form 10-Q filed by HealthStream Inc.